Knowledge, Attitude, and Practice of Foot Care and the Risk of Foot Ulcers in Diabetic Patients in Jeddah, Saudi Arabia: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVE: Diabetic patients in Saudi Arabia are often underinformed about proper diabetic foot care. This study aims to determine the knowledge, attitude, and practice of the risk factors of diabetic foot ulcers among diabetic patients in the Jeddah region of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was done on 210 diabetic patients attending the international diabetic center in Jeddah, Saudi Arabia, during the study period. A validated questionnaire was used to collect data about participants' demographics and knowledge, attitudes, and practices of diabetic foot care. RESULTS: Of the participants, 77 (36.7%) were aged 51-60 years; 161 (76.7%) were male; 153 (72.9%) had a university education; and approximately 138 (65%) had type 2 DM. A majority, 190 (90.5%), acknowledged that DM patients might have reduced foot sensation; 204 (97.1%) agreed that diabetics could develop gangrene; 188 (89.5%) concurred that poor foot sensation increases the risk of foot ulcers; and 193 (91.9%) agreed that poor blood flow to the feet heightens this risk. Among them, 152 (72.4%) demonstrated good knowledge about foot care and the risk of foot ulcers; eight (3.8%) exhibited a positive attitude; and 95 (45.2%) showed a good level of practice. Good knowledge was significantly higher among married patients, and good practice was notably higher among older patients (>50 years). A significant positive correlation was found between knowledge scores and both attitude and practice scores. CONCLUSION: The study revealed adequate knowledge and practice of foot care and the risk of foot ulcers among diabetic patients. However, a high percentage of negative attitudes toward these issues were observed.

The Influence of Honey and Hydrogel Products Therapy on Healing Time in Diabetic Foot.

BACKGROUND: Diabetic foot ulcer is a serious and common complication of diabetes that often leads to significant morbidity and even amputation if not properly treated. Current treatment options, such as wound dressing, have limitations in promoting efficient healing. There is a need for effective interventions that can expedite the healing process and enhance the time required for complete healing. METHODOLOGY: This prospective single-blinded randomized control trial studied diabetic mellitus type 2 patients with ulcer in their second-degree feet from February 2019 to February 2023 in the Diabetic Foot Center, King Fahad Specialist Hospital Al Qassim-KSA. RESULTS: This study involved 120 patients with a mean age of 59.64 ± 10.21. And 63% to 52.5% of them were males and 57% to 47.5% were females. The mean healing time was about 12.76 ± 4.08 days. Cases were divided into 4 equal groups with altered treatment procedures: honey alone, hydrogel alone, honey, and hydrogel combination alternately (3 intervention groups), and fucidin ointment or cream alone (1 control group), with 30 participants in each group. We revealed that the mean healing times for honey alone, hydrogel alone, and honey and hydrogel alternately were 12.20, 13.97, and 10.83 days, respectively. While it was 14.03 days in the control Fucidin ointment or cream [significantly P < .05 (P = .004)]. CONCLUSION: From the findings of the present study, we noticed that faster healing time among diabetic foot cases could be accomplished by treatment with a combination of honey and hydrogel alternately. Therefore, this therapy is effective in reducing the risk of diabetic foot ulcers.

External Fixation for Surgical Offloading of the Diabetic Foot.

The concept of surgical offloading with external fixation is especially relevant when managing diabetic patients with lower extremity wounds refractory to conservative treatment with traditional offloading. This article provides a case report and review of external fixation as a powerful device in accelerating wound healing and providing correction of osseous deformities simultaneously in the diabetic foot.

Acroangiodermatitis of Mali (Pseudo-Kaposi Sarcoma) Associated with Chronic Venous Insufficiency and Obesity: A Case Report.

INTRODUCTION: Acroangiodermatitis, also known as psesudo-Kapsoi sarcoma, is a rare and benign angioproliferative malady. It presents clinically as purple-colored plaques, patches, or nodules resembling Kaposi sarcoma and is often related to chronic venous insufficiency, arteriovenous malformation of the legs, paralyzed limbs, and residual limbs. Obesity is a risk factor for venous insufficiency and could be related to acroangiodermatitis. CASE REPORT: The authors report a case of acroangiodermatitis of the bilateral legs that was misdiagnosed for 3 years. The diagnosis was confirmed using histopathological and immunohistochemical examinations such as hematoxylin and eosin staining and CD34 immunostaining. Multiple modalities were utilized to treat the wounds, including serial debridement, compression dressings, and silver antimicrobial dressings. CONCLUSIONS: It should be stressed that chronic, nonhealing wounds should be biopsied to obtain a proper diagnosis.

Ankle Arthrodiastasis with Circular External Fixation for the Treatment of Posttraumatic Ankle Arthritis.

Ankle arthrodiastasis provides an alternative surgical treatment of the mild to moderate posttraumatic ankle arthritis. Ankle arthrodesis or ankle implant arthroplasty is usually reserved for the end-stage ankle arthritis and after conservative treatment options have been implicated for a long period of time. Ankle joint destructive procedures are often considered for the older and less active population with strict selected surgical criteria and prolonged rehabilitation. In either ankle joint-sparing or ankle destructive procedures, lower extremity deformity correction will need to be addressed before or at the time of index surgery for the overall patient's successful outcome.